Department of Plastic and Reconstructive Surgery, Plastic Surgery Unit, Mansoura University Hospital, Mansoura, Egypt.
Int Wound J. 2011 Oct;8(5):447-53. doi: 10.1111/j.1742-481X.2011.00815.x. Epub 2011 May 19.
Management of patients with large or recurrent pressure ulcerations can be complicated by the lack of available local flap, whether already used or because adjacent lesions make such flap insufficient for complete coverage. In this article, the gracilis muscle was modified to cover large defects without help from its cutaneous territory. Twelve ischeal pressure sores were treated between August 2007 and 2009 with the modified gracilis muscle flap in a single-staged procedure. Five ulcers were recurrent and seven patients have associated pressure ulcers. All reconstructions were successful. Mean patient age was 35 years and nearly all patients had multiple significant comorbidities, including associated ulcers, diabetes and urethrocutaneous fistula. All flaps and donor sites healed uneventfully. There was one complication presented as cellulites at the donor site. Follow-up in some cases extend up to 1·5 years. No recurrence was observed. The accordion gracilis muscle flap is a handy, safe and fast flap for reconstruction of recurrent, difficult ischeal pressure sores.
对于伴有大面积或复发性压疮的患者，由于缺乏可用的局部皮瓣（已经使用过或由于相邻病变导致皮瓣不足以完全覆盖），其治疗管理可能会变得复杂。本文介绍了一种改良的股薄肌肌皮瓣，可在无需其皮瓣区的帮助下覆盖大面积缺损。2007 年 8 月至 2009 年，12 例坐骨压疮患者采用改良股薄肌肌皮瓣一期手术治疗。5 例溃疡为复发性，7 例患者伴有压力性溃疡。所有重建均成功。患者平均年龄为 35 岁，几乎所有患者均有多种严重的合并症，包括合并溃疡、糖尿病和尿道皮肤瘘。所有皮瓣和供区均愈合良好，无并发症。一例患者供区出现蜂窝织炎。部分病例的随访时间长达 1.5 年，未见复发。改良的股薄肌肌皮瓣是一种方便、安全、快速的皮瓣，可用于重建复发性、难治性坐骨压疮。
